With or without credit, CME rules apply

The most innovative feature of a code that went into effect last month at Stanford University, says one of the its architects, is the extension of restrictions on pharmaceutical support to all educational events, regardless of whether credit is awarded.

Following an increasingly common trend among academic medical centers, Stanford bars all gifts, even small ones like pens.

What sets it apart is explicit language around education: Guidelines from the Accreditation Council on Continuing Medical Education (ACCME) apply even to non-accredited events.“The things that we're worried about in fact are the more informal lecture series, events, an educational lunch talk—the kinds of things that happen routinely and are absolutely not CME events,” said David Magnus, PhD, director of Stanford's Center for Biomedical Ethics and a member of the task force that wrote the policy.

The task force studied other academic policies on industry interaction, and almost all of them had “loopholes” allowing unaccredited educational events, Magnus said.

One idea proposed last January in the Journal of the American Medical Association involved putting all educational funds into a single, central pot for the medical center to distribute. Magnus said Stanford considered that option but decided to rely on ACCME's “already well-understood rules around CME.”

Other medical center codes may function similarly, but Stanford's policy of explicitly making all educational activities adhere to these rules “has made a thin bright line clearer,” said R. Van Harrison, PhD, director, University of Michigan Office of CME.

Michigan's policy on industry interaction—co-drafted by Harrison—has been on the books since 2003 and was emulated by the Hospital of the University of Pennsylvania, which this year tightened rules to bar reps from handing out all gifts and free pizza. Yale University did the same. Such policies “will not be universal,” predicted Harrison, but “will over time become more and more the norm.”